青少年体重指数与 179 万以色列男女患结肠癌和直肠癌风险的关系：一项基于人群的研究。

Adolescent body mass index and risk of colon and rectal cancer in a cohort of 1.79 million Israeli men and women: A population-based study.

机构信息

Gastroenterology Department, Rabin Medical Center, Petach Tikva, Israel.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Cancer. 2017 Oct 15;123(20):4022-4030. doi: 10.1002/cncr.30819. Epub 2017 Jul 24.

DOI:10.1002/cncr.30819

PMID:28736986

Abstract

BACKGROUND

This study examined the association between the body mass index (BMI) in late adolescence and the risk of colon and rectal cancer.

METHODS

This study analyzed a cohort of 1,087,358 Jewish men and 707,212 Jewish women who underwent health examinations at the ages of 16 to 19 years between 1967 and 2002 and were followed by linkage to the national cancer registry up to 2012. Cox regression was used to estimate hazard ratios (HRs) for cancer according to age- and sex-adjusted BMI percentiles from the US Centers for Disease Control and Prevention (overweight, 85th percentile to <95th percentile; obesity, ≥95th percentile).

RESULTS

Over a median follow-up of 23 years, 2967 incidence cases of colorectal cancer, including 1977 among men (1403 in the colon and 574 in the rectum) and 990 among women (764 in the colon and 226 in the rectum), were identified. Overweight and obesity were associated with the risk for colon cancer among both men (HR for overweight, 1.53; 95% confidence interval [CI], 1.28-1.84; HR for obesity, 1.54; 95% CI, 1.15-2.06; statistically significant from a BMI of 23.4 kg/m [spline analysis]) and women (HR for overweight, 1.54; 95% CI, 1.22-1.93; HR for obesity, 1.51; 95% CI, 0.89-2.57; significant from a BMI of 23.6 kg/m ). Obesity, but not overweight, was associated with a risk for rectal cancer among men (HR, 1.71; 95% CI, 1.11-2.65; significant from a BMI of 29.6 kg/m ) and women (HR, 2.03; 95% CI, 0.90-4.58; significant from a BMI of 30.6 kg/m ).

CONCLUSIONS

Being overweight or obese in adolescence was associated with an increased risk of subsequent colon cancers in men and women, whereas obesity was associated with rectal cancer. Cancer 2017;123:4022-30. © 2017 American Cancer Society.

摘要

背景

本研究旨在探讨青少年后期的体重指数（BMI）与结肠癌和直肠癌风险之间的关系。

方法

本研究分析了一个队列，其中包括 1087358 名犹太男性和 707212 名犹太女性，他们在 1967 年至 2002 年期间接受了 16 至 19 岁的健康检查，并通过与国家癌症登记处的链接进行了随访，随访时间截至 2012 年。使用 Cox 回归估计根据美国疾病控制与预防中心（CDC）的 BMI 百分位数（超重，第 85 百分位至<第 95 百分位；肥胖，≥第 95 百分位）计算的癌症的危险比（HRs）。

结果

在中位随访 23 年期间，共发现 2967 例结直肠癌的发病病例，其中男性 1977 例（结肠 1403 例，直肠 574 例），女性 990 例（结肠 764 例，直肠 226 例）。超重和肥胖与男性结肠癌的风险相关（超重的 HR，1.53；95%置信区间[CI]，1.28-1.84；肥胖的 HR，1.54；95%CI，1.15-2.06；与 BMI 为 23.4kg/m[样条分析]有统计学意义）和女性（超重的 HR，1.54；95%CI，1.22-1.93；肥胖的 HR，1.51；95%CI，0.89-2.57；与 BMI 为 23.6kg/m 有统计学意义）。肥胖（但非超重）与男性直肠癌的风险相关（HR，1.71；95%CI，1.11-2.65；与 BMI 为 29.6kg/m 有统计学意义）和女性（HR，2.03；95%CI，0.90-4.58；与 BMI 为 30.6kg/m 有统计学意义）。